The Effect of Diffuse Liver Diseases on the Occurrence of Liver Metastases in Cancer Patients: A Systematic Review and Meta-Analysis

Abstract

This systematic review with meta-analysis aimed to assess the effect of diffuse liver diseases (DLD) on the risk of synchronous (S-) or metachronous (M-) liver metastases (LMs) in patients with solid neoplasms. Relevant databases were searched for systematic reviews and cross-sectional or cohort studies published since 1990 comparing the risk of LMs in patients with and without DLD (steatosis, viral hepatitis, cirrhosis, fibrosis) in non-liver solid cancer patients. Outcomes were prevalence of S-LMs, cumulative risk of M-LMs and LM-free survival. Risk of bias (ROB) was assessed using the Newcastle-Ottawa Scale. We report the pooled relative risks (RR) for S-LMs and hazard ratios (HR) for M-LMs. Subgroup analyses included DLD, primary site and continent. Nineteen studies were included (n = 37,591 patients), the majority on colorectal cancer. ROB appraisal results were mixed. Patients with DLD had a lower risk of S-LMs (RR 0.50, 95% CI 0.34–0.76), with a higher effect for cirrhosis and a slightly higher risk of M-LMs (HR 1.11 95% CI, 1.03–1.19), despite a lower risk of M-LMs in patients with vs without viral hepatitis (HR 0.57, 95% CI 0.40–0.82). There may have been a publication bias in favor of studies reporting a lower risk for patients with DLD. DLD are protective against S-LMs and slightly protective against M-LMs for viral hepatitis only.

Frequency of Hepatic Metastatic Disease in Patients with Stage IV Breast Cancer Is Similar for Steatotic and Non-Steatotic Livers

“…a higher frequency of hepatic steatosis in patients with higher BMIs, an expected finding, we found no association between hepatic steatosis and any of the evaluated tumor or patient characteristics. Despite studies in other solid tumors, 18,29,30 mostly in the colorectal cancer population, there are (to our knowledge) only 2 previously published studies (both retrospective) addressing a similar question in a population of patients with breast cancer. Duran et al 16 evaluated hepatic steatosis with CT in 107 consecutive patients with metastatic breast cancer and found the frequency of hepatic metastases was significantly higher in patients with hepatic steatosis (46.4% vs 22.8%, P = .018).…”

“…Conflicting results concerning the effects of hepatic steatosis on the incidence of liver metastases are not unique to breast cancer but rather have been reported for multiple other solid tumor types as well. 18 …”

“…Conflicting results concerning the effects of hepatic steatosis on the incidence of liver metastases are not unique to breast cancer but rather have been reported for multiple other solid tumor types as well. 18 Although histopathology is the gold standard for diagnosing and quantifying hepatic steatosis, 19,20 the relative amount of lipid within the hepatic parenchyma can be accurately calculated noninvasively with various imaging methods. 21 These non-invasive approaches mitigate risks associated with liver biopsy, including life-threatening hemorrhage.…”

Colorectal Surgery in Patients with Liver Cirrhosis: A Systematic Review

“…In the same study, the OS for stage 0‐II was 66.3% and 45.5% for stage III‐IV [21]. It is postulated that the diseased liver maybe protective against liver metastases as it is a hostile environment for the liver metastasis to occur due to the complex interplay between the tumour and host cells that modifies the liver microenvironment [39]. Han et al demonstrated that lungs were the common site of metastasis in liver cirrhosis patients as compared to the liver in the non‐cirrhosis group [22].…”

Kontrastverstärkte Sonografie (CEUS) zur Diagnostik fokaler Leberläsionen

“…zelluläres Karzinom (HCC) handelt, sehr groß [51,52]. Während Patienten mit Leberzirrhose auch häufiger ein intrahepatisches Cholangiokarzinom entwickeln als die Normalbevölkerung, werden Metastasen nur selten in einer zirrhotischen Leber angetroffen [53]. Sie sind jedoch die häufigsten malignen Läsionen in der nicht-zirrhotischen Leber.…”